PRN 1381/PRN1381 Final Exam V2 |
Principles of Pharmacology Q&A with
Rationale | Rasmussen University
1. Which pharmacokinetic process is primarily affected in a patient with chronic liver disease?
A. Metabolism
B. Absorption
C. Distribution
D. Excretion
Answer: A
Rationale: Metabolism is the biochemical transformation of a drug into an inactive
metabolite, which primarily occurs in the liver. In patients with liver disease, enzymatic
activity is decreased, leading to slower drug processing. This increase in drug
concentration can result in toxicity if doses are not adjusted appropriately.
2. A nurse is administering a drug that has a high ‘first-pass effect.’ Which route should be
avoided to ensure maximum bioavailability?
A. Intravenous
B. Sublingual
C. Transdermal
D. Oral
,Answer: D
Rationale: The first-pass effect refers to the metabolism of a drug by the liver before it
reaches systemic circulation. Oral medications are absorbed in the GI tract and carried via
the portal vein directly to the liver. Routes such as IV, sublingual, or transdermal bypass
this initial hepatic metabolism, allowing more drug to reach the target site.
3. A patient is prescribed a drug with a narrow therapeutic index. What is the priority nursing
action?
A. Encourage increased fluid intake
B. Monitor serum drug levels closely
C. Administer the drug with food
D. Wait for symptoms of toxicity before calling the provider
Answer: B
Rationale: A narrow therapeutic index means that the difference between a therapeutic
dose and a toxic dose is very small. Close monitoring of blood levels is essential to ensure
safety and efficacy for the patient. Without precise monitoring, the patient is at a
significantly higher risk for life-threatening complications.
4. What is the primary purpose of the ‘Medication Reconciliation’ process during hospital
admission?
A. To ensure the patient can afford their prescriptions
B. To create a list of medications the patient was taking at home
, C. To prevent medication errors such as omissions or duplications
D. To explain the side effects of new medications
Answer: C
Rationale: Medication reconciliation involves comparing the patient’s current list of home
medications with the new orders in the hospital. This process is critical for identifying
discrepancies that could lead to drug-drug interactions or dosing errors. It ensures that the
transition of care is safe and that all necessary treatments are continued correctly.
5. A nurse is caring for an older adult patient. Which physiological change associated with
aging most affects drug distribution?
A. Increased total body water
B. Reduced serum albumin levels
C. Decreased body fat percentage
D. Increased gastric acidity
Answer: B
Rationale: Older adults often have reduced serum albumin, which is the primary protein
drugs bind to in the bloodstream. A decrease in albumin leads to more ‘free’ or unbound
drug circulating in the plasma, which increases the risk of toxicity. This physiological shift
requires nurses to monitor for exaggerated drug effects even at standard doses.
Principles of Pharmacology Q&A with
Rationale | Rasmussen University
1. Which pharmacokinetic process is primarily affected in a patient with chronic liver disease?
A. Metabolism
B. Absorption
C. Distribution
D. Excretion
Answer: A
Rationale: Metabolism is the biochemical transformation of a drug into an inactive
metabolite, which primarily occurs in the liver. In patients with liver disease, enzymatic
activity is decreased, leading to slower drug processing. This increase in drug
concentration can result in toxicity if doses are not adjusted appropriately.
2. A nurse is administering a drug that has a high ‘first-pass effect.’ Which route should be
avoided to ensure maximum bioavailability?
A. Intravenous
B. Sublingual
C. Transdermal
D. Oral
,Answer: D
Rationale: The first-pass effect refers to the metabolism of a drug by the liver before it
reaches systemic circulation. Oral medications are absorbed in the GI tract and carried via
the portal vein directly to the liver. Routes such as IV, sublingual, or transdermal bypass
this initial hepatic metabolism, allowing more drug to reach the target site.
3. A patient is prescribed a drug with a narrow therapeutic index. What is the priority nursing
action?
A. Encourage increased fluid intake
B. Monitor serum drug levels closely
C. Administer the drug with food
D. Wait for symptoms of toxicity before calling the provider
Answer: B
Rationale: A narrow therapeutic index means that the difference between a therapeutic
dose and a toxic dose is very small. Close monitoring of blood levels is essential to ensure
safety and efficacy for the patient. Without precise monitoring, the patient is at a
significantly higher risk for life-threatening complications.
4. What is the primary purpose of the ‘Medication Reconciliation’ process during hospital
admission?
A. To ensure the patient can afford their prescriptions
B. To create a list of medications the patient was taking at home
, C. To prevent medication errors such as omissions or duplications
D. To explain the side effects of new medications
Answer: C
Rationale: Medication reconciliation involves comparing the patient’s current list of home
medications with the new orders in the hospital. This process is critical for identifying
discrepancies that could lead to drug-drug interactions or dosing errors. It ensures that the
transition of care is safe and that all necessary treatments are continued correctly.
5. A nurse is caring for an older adult patient. Which physiological change associated with
aging most affects drug distribution?
A. Increased total body water
B. Reduced serum albumin levels
C. Decreased body fat percentage
D. Increased gastric acidity
Answer: B
Rationale: Older adults often have reduced serum albumin, which is the primary protein
drugs bind to in the bloodstream. A decrease in albumin leads to more ‘free’ or unbound
drug circulating in the plasma, which increases the risk of toxicity. This physiological shift
requires nurses to monitor for exaggerated drug effects even at standard doses.
